Inspection on 24/05/05 for Arlington House

This inspection was carried out on 24th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Arlington House 10/02/09

Arlington House 13/02/07

Arlington House 24/01/06

Arlington House 27/01/05

Arlington House 21/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Arlington House 88 Ackers Road Stockton Heath Warrington Cheshire, WA4 2EA Lead Inspector Anthony Groom Unannounced 24 May 2005 at 0940 Hrs. th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Arlington House Address 88 Ackers Road Stockton Heath Warrington Cheshire, WA4 2EA 01925 267576 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Neil Allcock Rose Jewel Care Home 14 Category(ies) of OP Old age 65 years and over (14) registration, with number of places Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 14 service users in the category of OP (old age not falling within any other category) 2. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 3. The matters detailed in the attached schedule of requirements must be completed in the stated timescales Date of last inspection 27th January 2005 Brief Description of the Service: Arlington House is a two storey detached property set in its own grounds in a residential area close to Stockton Heath village. The home is situated on a bus route. The home provides accommodation and personal care for up to fourteen elderly service users. Accommodation comprises ten single and two double bedrooms, a lounge, conservatory, dining room, two bathrooms and three toilets. The home changed ownership in 2004. It is staffed by a manager, who is registered with the Commission for Social Care Inspection, and a team of care assistants, with ancillary staff employed for housekeeping and catering duties. Personal care is provided by the staff in the home, and any health and nursing needs are met by the community health services team. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 26 May 2005 over seven hours by Anthony Groom. The owner, and two senior care assistants were on duty and twelve residents were living in the home. The home’s registered manager, who was not working on the day of the inspection, visited the home for three hours to offer clarification regarding several matters. During the inspection six residents were spoken with. A range of care, health, safety and maintenance records were examined and a tour of the premises, including all shared areas and most bedrooms, was undertaken. What the service does well: What has improved since the last inspection? What they could do better: The home must improve its procedures for assessing the individual needs of residents and for producing care plans that show what actions staff need to take to ensure that people who live at Arlington House receive the best quality care. More regular trips and outing should be organised for residents in order to provide greater variation in their daily lives and for them to keep in touch with the wider community. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5 Whilst all residents are assessed by the home’s manager before moving into Arlington House, the documentation used for the assessment must be revised so that all aspects of an individual’s health and personal care needs are identified in order that an accurate care plan can be compiled. EVIDENCE: Four care files were seen and all contained some evidence that an assessment of residents’ individual needs had been carried out by the home’s manager. In several cases a copy of the social services’ standard care management assessment was also available. There was, however, inconsistency in the information shown in those assessments which were carried out using the home’s own documentation and, as there was no standard, comprehensive format, this could lead to important aspects of a resident’s needs being overlooked. See Requirement 1 Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 9 All residents are encouraged to visit the home before moving in; one resident confirmed that she had been given this opportunity but said that she had asked her daughter to look around several homes on her behalf and that she was very happy with the choice her daughter had made. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Care plans were not clear in showing what residents’ individual needs were and the actions required by staff in order to meet these, which could affect the quality of care they receive at the home. EVIDENCE: Four care files were seen and all contained a range of care plans with standard headings e.g. personal care and physical well-being, sight, hearing and communication, oral health, footcare etc. These did not, however, relate to the home’s own assessment documentation and were not clear in specifying what each residents’ individual health and social care needs were, what the overall aim of each care plan was and what action staff needed to take to meet residents’ needs. Work must be undertaken to establish a clear link between the home’s assessment procedure and the process for compiling individual care plans so that the needs of all residents are met in a consistent way by all staff. Care plans did not contain any evidence of consultation with residents or their relatives and this could mean that their views and opinions are not included. See Requirements 2 and 3 Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 11 Observed interactions between staff and residents were warm and friendly. Residents said that they were well cared for and that staff at the home treated them courteously and with respect. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 Routines at the home are flexible to suit residents’ individual preferences. Although staff provide some activities within the home residents said that they would like more trips and outings to be arranged so they could engage more with life in the wider community. EVIDENCE: Residents said that routines within the home were flexible and that they could choose the time that they went to bed at night and got up in the morning. They also confirmed that they could chose to spend time in their own bedrooms if they wished. Regarding personal care arrangements, individuals commented that whilst they generally had their baths/showers at regular times, they could request an alternative time or day and that staff would try to accommodate them. Staff provide some activities in the home on a regular basis. Some residents, however, said that they were sometimes at a ‘loose end’ and would like more activities to be arranged. In particular, several residents said that they would like the home to organise more trips and outings so that they could maintain contact with the ‘outside world’. These matters were discussed with one of the home’s owners who acknowledged that this was an area where improvements could be made. See Recommendation 1 Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 13 Residents said that they were able to receive visitors at any reasonable time and there was evidence of this on the afternoon of the inspection. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents know how to make a complaint and the home’s owners recognise the importance of listening to and acting on residents’ views about the home. Staff have received training so that they can help to protect service users from harm or abuse. EVIDENCE: The home has a written complaints procedure which includes contact details for the Commission for Social Care Inspection (CSCI). Residents were aware of how to make a complaint should they be unhappy about the service they receive at Arlington House. Whilst there was no record of complaints received by the home, the owner reported that no complaints had been received during twelve month period since he purchased Arlington House. He did, however, agree to introduce either a record book (or file), into which details of any future complaints or concerns expressed by residents - or any other people who have contact with the service - would be entered. There are written policies and procedures regarding the protection of vulnerable adults and all staff receive some training in this area as part of their induction. Some staff have also undertaken further training in adult protection by the local Borough Council Social Services Department. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 24 The home is generally well maintained and decorated and provides a comfortable and homely environment for residents who live there. There is an accessible walled garden to the rear which offers residents and their visitors a pleasant area in which to walk or sit. EVIDENCE: A tour of the property confirmed that the home was generally well maintained and decorated, although, in the dining room, some wallpaper was starting to peel. There is a conservatory extension to the lounge which has pleasant views of the garden areas. The home’s walled garden was being used by several residents and a visitor on the afternoon of the inspection. The home currently has ten single and two double bedrooms. The owner is, however, considering converting one of the double bedrooms into two single bedrooms. As this will involve reducing the size of the upstairs bathroom, he has agreed to consult with residents and their relatives to ensure that they are happy with this proposal before proceeding. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 16 Most residents have their own single bedrooms which they are encouraged to personalise with their own belongings including pictures, ornaments and small items of furniture. Those bedrooms which were seen reflected the tastes and preferences of their occupants. Residents said that they were very happy with the accommodation that the home provides. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Staffing levels and skills are adequate to meet the residents’ needs. The home has a small staff group, with low turnover, which means that residents can get to know the people who care for them. Appropriate recruitment checks are carried out on all new staff members and this helps to protect the safety of people who live at the home. EVIDENCE: Staff rosters showed that agreed staffing levels were being maintained at the home and that there were always a minimum of two care staff members on duty at all times including overnight. The registered manager reported that seven of the fifteen staff had completed NVQ Level II training and, of these, two had also completed NVQ Level III training. See Recommendation 2 Staff recruitment records were checked for four staff members and these confirmed that satisfactory references and Criminal Records Bureau (CRB) disclosures had been obtained. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 18 Two staff members have completed formal induction training through a local training provider. The home’s own induction checklist does, however, need to be revised to remove reference to ‘wound care’ and ‘catheter care’ as these terms imply that nursing care is provided by the home. Training certificates provided evidence that staff had undertaken recent training in moving and handling, the administration of medicines and fire safety. Most staff had also completed training in emergency first aid. There is, however, a need to maintain accurate training and development records for all staff who work at the home. See Recommendation 3 Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The views’ of residents and their relatives are sought through the use of questionnaires in order to monitor the quality of the service provided by the home and make improvements, where necessary. Whilst effective policies and procedures are generally in place to protect the health, safety and welfare of residents and staff, a fire risk assessment for the premises has not yet been carried out. EVIDENCE: The home’s owners undertake a survey of the views of residents and their relatives on an annual or more frequent basis in order to monitor the quality of the service provided and a sample of some the responses received were available for inspection. There is, however, a need to collate the responses and present them in an easily readable format so that they can be shared more widely. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 20 Additionally, efforts should be made to obtain information from other people who have contact with the home e.g. district nurses, general practitioners, social workers and other professional visitors. See Recommendation 4 A number of health and safety and equipment maintenance records were seen and found to be satisfactory. These included fire alarm and emergency lighting systems, lift, hoist, fire extinguishers, boiler maintenance and Portable Appliance Testing (PAT). The Control Of Substances Hazardous to Health (COSHH) file was last reviewed in January 2002 and may now require further review. Whilst there was separate evidence that staff had undertaken training in fire prevention/action to be taken in the event of a fire, this was not recorded in the fire precautions record book. The owner did, however, agree to ensure that in future such training would be included within this record. An inspection was carried out by the local fire authority in November 2004. The one requirement made related to a fire risk assessment of the premises being compiled. The owner acknowledged that this work had not yet been undertaken. See Requirement 4 Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x x 3 x x STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x x x x 2 Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 14 Requirement Documentation used by the home for assessing the individual needs of residents must be revised to ensure that it is comprehensive and fit for purpose. All care plans must be revised to ensure that they are linked to the homes assessment procedures and that they clearly specify residents individual needs, the aims of the care plan and the actions required by staff. All care plans must contain evidence of consultation with residents and/or their relatives. A fire risk assessment of the premises must be undertaken and documented in accordance with guidance given by the local fire authority. Timescale for action 01/08/05 2. 7 15 31/08/05 3. 4. 7 38 15 23 31/08/05 As specified by the fire authority. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 23 Arlington House 1. 2. 3. 4. 12 28 30 33 The home should arrange a regular programme of trips and outings for residents. A minimum of 50 of care staff should achieve NVQ Level II in Care by 2005. A staff training and development plan should be produced for all staff who work at the home. Systems for monitoring the quality of the service provided by the home should be further developed to enable the results of surveys to be presented in an easily readable format and to include the views of other people who have contact with the service. Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Arlington House F51 F01 S60704 Arlington House V228589 240505 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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